Lisa Marie Villanueva, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-093553 Issued in IL

Practice address

101 S Washington Ave
Suite 122
Park Ridge, IL 60068-4200

Phone

(847) 692-6628

Fax

(847) 692-6891

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lvillanueva251107@direct.myadvocateaurora.org
• Direct secure messaging: lisa.villanueva@prpp.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Park Ridge Pediatrics PC

  • Pediatrics Physician
  • Park Ridge, IL
  • NPI 1518979327
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1972513331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON AVE",
            "address_2": "SUITE 122",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684200",
            "telephone_number": "847-692-6628",
            "fax_number": "847-692-6891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON AVE",
            "address_2": "SUITE 122",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684200",
            "telephone_number": "847-692-6628",
            "fax_number": "847-692-6891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-093553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093553",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvillanueva251107@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 S Washington Ave",
            "address_2": "Suite 122",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600684200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "101 S Washington Ave",
            "address_2": "Suite 122",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600684200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "101 S Washington Ave",
            "address_2": "Suite 122",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600684200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "101 S Washington Ave",
            "address_2": "Suite 122",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600684200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol Sue Victor, APN, CDE
• Babita Viegas Miller, PH.D.
• Marya Vieira
• Stacey K Vilione, PA-C
• Francis Villanueva, DO
• Sandy Villanueva
• Ruth E Vincent, LCPC, NCC
• Ravjot Kaur Virdi
• Dimitrina Vizinas, DO
• Nancy L Vogg

• Pediatrics Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.